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Virtual interviewers may help soldiers speak up about PTSD

Service members unwilling to open up about their PTSD in person may be more likely to speak with computer-generated virtual interviewers, newly published research suggests.

Due to their anonymity and rapport-building capabilities, these virtual interviewers could be uniquely positioned to break through soldiers’ fears of discrimination and career-affecting stigma and improve mental health care, Gale M. Lucas, senior research associate at the University of Southern California’s Institute for Creative Technologies, and colleagues wrote.

“We envisioned a technology system – a virtual human interviewer – whereby military service members can get feedback about their risk for PTSD in a safe place without stigma,” Lucas told MobiHealthNews in an email. “Our prior research has shown that, because its ‘just a computer’ (therefore safe and anonymous), this virtual human interviewer helps people to feel safe discussing sensitive issues like mental health symptoms.”

To investigate the effectiveness of a virtual interviewer, Lucas and colleagues conducted two studies: the first with 29 active-duty Colorado National Guard service members, and the other with 132 active duty service members as well as veterans. The researchers compared reporting of PTSD symptoms from the standard Post-Deployment Health Assessment (PDHA), an anonymized version of the PDHA, and the same PTSD symptom questions of the PDHA asked by a virtual human interviewer in the first study; for the second, only the anonymized PDHA and virtual interviewer were compared. The researchers noted that the PTSD symptom questions were slightly reworded for the virtual interviewer, so that they would be more conversational and fit in with the virtual interviewer’s rapport-building introduction.

Lucas and colleagues found that, in both studies, participants were significantly more likely to disclose their PTSD symptoms to the virtual interviewer than they were during the standard PDHA and, to a lesser degree, the anonymized version of the PDHA. Further analysis of the second study group revealed that the increase was primarily driven by interviewees who reported more subtle symptoms of PTSD, while there was no significant difference among the reporting rates of those whose symptoms were more severe. More participants reported symptoms on the anonymized PDHA than the standard, although the difference between these two formats was not statistically significant.

While the data suggest that virtual interviewers are better able to coax admissions of mental health issues from service members and veterans, the researchers warned that the difference could also be explained by the reworked, open-ended questions used by the interviewer. Further, some of the results may be subject to an “order effect” bias because the anonymized PDHA was consistently administered before the virtual interview. Still, they wrote, the potential of virtual human interviews is promising and supports prior data indicating the dual benefits of anonymity and rapport when working with service members who don’t want to open up.

“This research suggests there could be a benefit of putting virtual human interviewers in VA locations, for the use of our service members who are transitioning back to civilian life,” Lucas said. “Additionally, providing access to these kinds of technology to service members returning from deployment could serve as an important adjunct to the PDHA. … By receiving anonymous feedback from the virtual human interviewer that they are at risk for PTSD, they could be encouraged to seek help without having their symptoms flagged on their military record.”